BackgroundThe FACED score is an easy-to-use multidimensional grading system that has demonstrated an excellent prognostic value for mortality in patients with bronchiectasis. A Spanish group developed the score but no multicenter international validation has yet been published.MethodsRetrospective and multicenter study conducted in six historical cohorts of patients from Latin America including 651 patients with bronchiectasis. Clinical, microbiological, functional, and radiological variables were collected, following the same criteria used in the original FACED score study. The vital status of all patients was determined in the fifth year of follow-up. The area under ROC curve (AUC-ROC) was used to calculate the predictive power of the FACED score for all-cause and respiratory deaths and both number and severity of exacerbations. The discriminatory power to divide patients into three groups of increasing severity was also analyzed.ResultsMean (SD) age of 48.2 (16), 32.9% of males. The mean FACED score was 2.35 (1.68). During the follow up, 95 patients (14.6%) died (66% from respiratory causes). The AUC ROC to predict all-cause and respiratory mortality were 0.81 (95% CI: 0.77 to 0.85) 0.84 (95% CI: 0.80 to 0.88) respectively, and 0.82 (95% CI: 078–0.87) for at least one hospitalization per year. The division into three score groups separated bronchiectasis into distinct mortality groups (mild: 3.7%; moderate: 20.7% and severe: 48.5% mortality; p < 0.001).ConclusionsThe FACED score was confirmed as an excellent predictor of all-cause and respiratory mortality and severe exacerbations, as well as having excellent discriminative capacity for different degrees of severity in various bronchiectasis populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-017-0417-3) contains supplementary material, which is available to authorized users.
Bronchiectasis is a disease defined by a permanent and usually progressive bronchial dilation associated with multiple exacerbations and decreased health-related quality of life [1–3]. Improvement in the current knowledge of this condition's pathophysiology has clearly highlighted its complex and heterogeneous profile, whose severity or prognosis cannot be defined using a single variable [4]. Accordingly, multidimensional scores including demographical, clinical, microbiological and radiological data have recently been developed and validated as useful tools to better evaluate the disease's severity and prognosis: FACED (forced expiratory volume in 1 s (FEV1), age, chronic colonisation by Pseudomonas aeruginosa, radiological extension and dyspnoea), E-FACED (FACED plus exacerbations) and the bronchiectasis severity index (BSI) [5–8].
Background: Over the last years, increasing attention has been focused on the prevalence of obstructive sleep apnea (OSA) in idiopathic pulmonary fibrosis (IPF). Objective: To determine the prevalence of OSA in a group of patients diagnosed with IPF. Materials and Methods: Analytic retrospective study. Data were collected from the medical records of all patients diagnosed with IPF who had polysomnography requested as part of the study protocol in patients with interstitial lung diseases (ILD). Results: 36 patients were studied, 26 of who were male. The mean age was 67.55 ± 6.39 years old. Mean forced vital capacity (FVC) was 2.12 ± 0.76 liters. The mean body mass index (BMI) was 28.78 ± 4.24. The Epworth Sleepiness Scale (ESS) average was 7.55 ± 5.01 and the mean apnea hypopnea index (AHI) was 12.69 ± 19.40. Of all the patients studied, 17 (47.22%) had OSA with an AHI ≥ 5. Of these, 9 (25%) had AHI ≥ 10. In the group of patients with OSA (n = 17), 9 (52.94%) had mild OSA (AHI between 5 and 15) and 8 (47.05%) moderate to severe OSA (AHI ≥ 15). Conclusions: In our series of 36 patients with IPF we found a prevalence of OSA of 47.22%. We found no correlation between ESS and the BMI with the presence of OSA in these patients, suggesting that these assessments may be less than optimal screening tools for OSA in IPF.
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